7 Things to Know About Rimegepant (Nurtec ODT)

Written by Shishira Sreenivas
Medically Reviewed by Melinda Ratini, MS, DO on March 04, 2023
4 min read

Rimegepant (Nurtec ODT) is a prescription medication that’s designed to stop a migraine headache once it starts as well as prevent future migraine episodes. Here are seven things you should know about rimegepant if you’re on this medication or planning to take it. 

The medication belongs to a class of drugs called calcitonin gene-related peptide (CGRP) receptor antagonist. 

When you get a migraine attack, there’s a buildup of a protein called CGRP in your brain. The protein attaches itself to receptors in your brain and activates them. This is thought to cause the searing pain you feel during a migraine, along with the inflammation and widening of blood vessels that are also part of the migraine process. 

By keeping CGRP from attaching to the receptors, rimegepant can stop migraine pain in its tracks. If you take it regularly, the same action stops migraines from developing in the first place.

It’s effective on episodic migraines, which is when you have attacks on 14 or fewer days per month. It works on migraines with or without auras. Auras are sensory problems you notice in the early stages of a migraine attack, like seeing spots or having a tingling feeling.   

The drug comes as a dissolvable tablet. Once you place it on your tongue, it disintegrates within a few seconds and enters your bloodstream.

You don’t need to drink water with it or swallow it whole. You can also place it under your tongue. But don’t chew, crush, or split the tablets. 

When you take it during an attack, you usually see migraine symptoms like pain and sensitivity to light and sound go away within 1-2 hours. The drug’s benefits can last up to 2 days. 

For prevention, you take one tablet every other day to help you stay ahead of migraine attacks. 

A clinical study found that for most people, rimegepant reduced the number of migraine days they had every week within 1 week after they started taking the drug. After 12 weeks, they saw a significant drop in how many migraine days they had each month. 

Any drug can potentially cause side effects But not everyone gets them. Some of the more common side effects of rimegepant are:

  • Nausea
  • Upset stomach
  • Stomach pain

Usually, side effects are minor and tend to improve after you’ve been taking the drug for a few weeks. But if they bother you a lot or don’t go away, tell your doctor. 

While rare, it’s possible for some people to have a serious allergic reaction to the drug. 

Call your doctor or 911 right away if you notice signs of a reaction, like:

  • Rashes
  • Hives
  • Itching
  • Swollen, blistered, or peeling skin that’s red or painful to touch 
  • Fever
  • Wheezing
  • Tightness in your chest or throat
  • Trouble breathing
  • Difficulty swallowing or talking
  • Swelling in the mouth, face, lips, tongue, or throat.

You can also report serious effects to the FDA at 800 FDA-1088 (800-332-1088) or inform the drug manufacturer directly. 

Rimegepant is only available in a dose of 75 milligrams. Closely follow your doctor’s instructions when you take it. 

To treat a migraine, you generally take the drug as needed. But don’t take more than one tablet in a 24-hour period. 

If you’re taking it to prevent frequent episodic migraines, you’ll take it once every other day. Don’t take more than 18 doses per month, since doctors don’t know whether that’s safe. 

Always use the medication as soon as you take it out of the foil packaging. 

Don’t skip doses. If you miss a scheduled dose, take it as soon as you remember. But don’t double up your doses or take extra ones to make up for it. If it’s nearly time for the next dose, just wait and take it on your scheduled day.

If you think you’ve overdosed on rimegepant, call the Poison Control center at (800) 222-1222 or get medical help right away. 

Rimegepant isn’t right for everyone who gets migraines. Before you take it, tell your doctor about other medical conditions you might have and give a detailed medical history. 

Also, let your doctor know whether you drink alcohol, and if so, how many times per week. Make sure they know about any prescription medications, over-the-counter drugs, and vitamins or supplements you take. 

Rimegepant is only approved for adults, since its safety in children hasn’t been established. 

Don’t take rimegepant if you:

  • Have serious liver problems
  • Have end-stage kidney disease
  • Are on dialysis
  • Are pregnant
  • Are breastfeeding

Experts don’t know whether it’s safe for babies during pregnancy or nursing. If you’re planning to get pregnant or breastfeed, tell your doctor ahead of time. 

Currently, Rimegepant is sold only under the brand name Nurtec ODT. No generic option is available.